The incidence of accessory bones of the foot and their clinical significance

Objectives: Accessory bones of the foot are often con¬fused with avulsion fractures. This study was designed to investigate the incidence of accessory bones of the foot. Methods: Anteroposterior and lateral foot radiographs of 464 male patients with an age range of 20 to 46 years were examined with regard to the presence, incidence, and distribution of accessory bones. Identification of the accessory bones were made according to the Kohler clas¬sification. Results: Of 464 radiographs, accessory bones were identi¬fied in 85 feet (18.3%), all of which were symptomless. The most common accessory bones in descending order were os peroneum (31.8%), os naviculare (28.2%), os trigonum (23.5%), os vesalianum (5.9%), os supranaviculare (3.5%), os infranaviculare (3.5%), os supratalare (2.4%), and os intermetatarseum (1.2%). Conclusion: Accessory bones of the foot should be well recognized and their clinical significance should be appreciated in order to decrease the rate of incorrect diag¬noses and unnecessary orthopedic consultations on initial presentations of patients with foot complaints.